Provider Demographics
NPI:1144350828
Name:MANNING, JERE C (DDS)
Entity type:Individual
Prefix:
First Name:JERE
Middle Name:C
Last Name:MANNING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 STEEPLECHASE LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1013
Mailing Address - Country:US
Mailing Address - Phone:615-662-8548
Mailing Address - Fax:
Practice Address - Street 1:129 BELLE FOREST CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2103
Practice Address - Country:US
Practice Address - Phone:615-646-2453
Practice Address - Fax:615-646-5387
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice